Individual
ROBERTO P CORPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
17830
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044237
BCBS PROVIDER NUMBER
—
01
—
17830
LICENSE
KY
05
—
64178304
—
KY
Enumeration date
09/15/2006
Last updated
01/08/2015
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